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Article: Rare/cryptic Aspergillus species infections and importance of antifungal susceptibility testing

TitleRare/cryptic Aspergillus species infections and importance of antifungal susceptibility testing
Authors
Keywordsantifungal susceptibility testing
Aspergillus
cryptic species
identification
sequencing
Issue Date2020
PublisherWiley-Blackwell Verlag GmbH. The Journal's web site is located at http://www.blackwellpublishing.com/journals/MYC
Citation
Mycoses, 2020, Epub 2020-09-11 How to Cite?
AbstractBackground: The number of patients infected with Aspergillus rose dramatically in recent years. However, studies on the clinical spectrum and antifungal susceptibilities of non‐classical (non‐fumigatus, non‐flavus, non‐niger and non‐terreus) pathogenic Aspergillus species are very limited. Objectives: We examined the clinical spectrum and antifungal susceptibilities of 34 non‐duplicated, non‐classical Aspergillus isolates collected from Hong Kong, Shenzhen and Shanghai. Methods: The Aspergillus isolates were identified by internal transcribed spacer, partial BenA and partial CaM sequencing and phylogenetic analyses. Susceptibility testing against eight antifungals was performed following the European Committee for Antimicrobial Susceptibility Testing's methodology. Results: The 34 Aspergillus isolates were identified as 14 different rare/cryptic species of four sections (Flavi [n = 8], Nidulantes [n = 8], Nigri [n = 17] and Restricti [n = 1]). Except for one patient whose clinical history could not be retrieved, 72.7% of the remaining patients had underlying conditions predisposing them to Aspergillus infections. The most common diseases were pulmonary infections (n = 15), followed by skin/nail infections (n = 6), chronic otitis externa and/or media (n = 5), wound infections (n = 2) and mastoiditis/radionecrosis (n = 1), while three were colonisations. Five patients succumbed due to the infections during the admission, and another two died 5 years later because of chronic pulmonary aspergillosis. Antifungal susceptibility testing showed that they possessed different susceptibility profiles compared to the classical Aspergillus species. The majority of isolates characterised were sensitive or wild‐type to amphotericin B. The minimum effective concentrations for all the three echinocandins were also low. Conclusion: Susceptibility testing should be performed for infections due to these rare/cryptic Aspergillus species to guide proper patient management.
Persistent Identifierhttp://hdl.handle.net/10722/287284
ISSN
2019 Impact Factor: 3.575
2015 SCImago Journal Rankings: 0.921

 

DC FieldValueLanguage
dc.contributor.authorTsang, CC-
dc.contributor.authorTANG, JYM-
dc.contributor.authorYe, H-
dc.contributor.authorXing, F-
dc.contributor.authorLo, SKF-
dc.contributor.authorXiao, C-
dc.contributor.authorHan, L-
dc.contributor.authorWu, AKL-
dc.contributor.authorNgan, AHY-
dc.contributor.authorLaw, KC-
dc.contributor.authorTo, YN-
dc.contributor.authorSze, DTT-
dc.contributor.authorChim, OHY-
dc.contributor.authorHui, TWS-
dc.contributor.authorLeung, CWH-
dc.contributor.authorZhu, T-
dc.contributor.authorYao, C-
dc.contributor.authorTse, BPH-
dc.contributor.authorLau, SKP-
dc.contributor.authorWoo, PCY-
dc.date.accessioned2020-09-22T02:58:39Z-
dc.date.available2020-09-22T02:58:39Z-
dc.date.issued2020-
dc.identifier.citationMycoses, 2020, Epub 2020-09-11-
dc.identifier.issn0933-7407-
dc.identifier.urihttp://hdl.handle.net/10722/287284-
dc.description.abstractBackground: The number of patients infected with Aspergillus rose dramatically in recent years. However, studies on the clinical spectrum and antifungal susceptibilities of non‐classical (non‐fumigatus, non‐flavus, non‐niger and non‐terreus) pathogenic Aspergillus species are very limited. Objectives: We examined the clinical spectrum and antifungal susceptibilities of 34 non‐duplicated, non‐classical Aspergillus isolates collected from Hong Kong, Shenzhen and Shanghai. Methods: The Aspergillus isolates were identified by internal transcribed spacer, partial BenA and partial CaM sequencing and phylogenetic analyses. Susceptibility testing against eight antifungals was performed following the European Committee for Antimicrobial Susceptibility Testing's methodology. Results: The 34 Aspergillus isolates were identified as 14 different rare/cryptic species of four sections (Flavi [n = 8], Nidulantes [n = 8], Nigri [n = 17] and Restricti [n = 1]). Except for one patient whose clinical history could not be retrieved, 72.7% of the remaining patients had underlying conditions predisposing them to Aspergillus infections. The most common diseases were pulmonary infections (n = 15), followed by skin/nail infections (n = 6), chronic otitis externa and/or media (n = 5), wound infections (n = 2) and mastoiditis/radionecrosis (n = 1), while three were colonisations. Five patients succumbed due to the infections during the admission, and another two died 5 years later because of chronic pulmonary aspergillosis. Antifungal susceptibility testing showed that they possessed different susceptibility profiles compared to the classical Aspergillus species. The majority of isolates characterised were sensitive or wild‐type to amphotericin B. The minimum effective concentrations for all the three echinocandins were also low. Conclusion: Susceptibility testing should be performed for infections due to these rare/cryptic Aspergillus species to guide proper patient management.-
dc.languageeng-
dc.publisherWiley-Blackwell Verlag GmbH. The Journal's web site is located at http://www.blackwellpublishing.com/journals/MYC-
dc.relation.ispartofMycoses-
dc.rightsPreprint This is the pre-peer reviewed version of the following article: [FULL CITE], which has been published in final form at [Link to final article using the DOI]. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. Postprint This is the peer reviewed version of the following article: [FULL CITE], which has been published in final form at [Link to final article using the DOI]. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.-
dc.subjectantifungal susceptibility testing-
dc.subjectAspergillus-
dc.subjectcryptic species-
dc.subjectidentification-
dc.subjectsequencing-
dc.titleRare/cryptic Aspergillus species infections and importance of antifungal susceptibility testing-
dc.typeArticle-
dc.identifier.emailTsang, CC: microbioct@connect.hku.hk-
dc.identifier.emailWu, AKL: alanklwu@hkucc.hku.hk-
dc.identifier.emailNgan, AHY: nganhy@hku.hk-
dc.identifier.emailChim, OHY: hychimaa@hku.hk-
dc.identifier.emailLau, SKP: skplau@hkucc.hku.hk-
dc.identifier.emailWoo, PCY: pcywoo@hkucc.hku.hk-
dc.identifier.authorityTsang, CC=rp02492-
dc.identifier.authorityLau, SKP=rp00486-
dc.identifier.authorityWoo, PCY=rp00430-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1111/myc.13158-
dc.identifier.pmid32918365-
dc.identifier.scopuseid_2-s2.0-85092021549-
dc.identifier.hkuros314470-
dc.identifier.volumeEpub 2020-09-11-
dc.publisher.placeGermany-

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